Service Frontline Research Articles

Does the Environment Influence the Frequency of Concussion Incidence in Professional Football?

BackgroundSports-related concussion is a major cause of mild traumatic brain injury (mTBI). It is possible that environmental factors, such as temperature, humidity, and stadium's altitude, may influence the overall incidence of concussions during a game.PurposeTo examine the impact of environmental factors, such as temperature, humidity, barometric pressure, and dew point, on concussion incidence.MethodsPublic Broadcasting Service (PBS) FRONTLINE Concussion Watch was used to collect injury data on 32 NFL teams during regular season games from 2012 to 2015. Weather data points were collected from Weather Underground. Concussion incidence per game, the probability of a concussion during a game, and a difference in mean game-day temperature, humidity, dew point, and barometric pressure between concussion and concussion-free games were calculated. Our analysis included t-tests, analysis of variance (ANOVA), multivariate correlation tests, and logistic and Poisson regression. ResultsOverall, 564 concussions were reported. There were 411 games with concussions and 549 games without concussions. We observed a significant decrease in concussion incidence with increasing temperature, both when the temperature was divided into 20oF increments or into quartiles (p = 0.005 and p = 0.002, respectively). We identified a statistically significant lower mean-game day temperature in concussion games compared to concussion-free games (p < 0.0006). We also observed a significant decrease in the incidence of concussion per game with increasing dew point. There was no significant difference in concussion incidence in barometric pressure and humidity. The logistic regression model predicted a decrease in the probability of a concussion in games with higher temperatures and dew points.ConclusionsNational Football League (NFL) players experienced an increased risk of concussion during football games played in colder temperatures and at lower dew points. Further research on environmental effects on concussions may aid in improving player safety in football leagues.

On the service frontline: Israeli Arab-Palestinian men in a call-center

Intersectionality is applied to gender-occupation-minority inconsistent hierarchies, to as to explore the workplace-experience of Israeli Arab-Palestinian men service workers and unveil the multiple-geographies it contains. In-depth semi-structured interviews with 24 suchlike men emphasize complexity as the key feature of their intersectional experience. Whereas masculinity and Israeli-Palestinianess are forged against the feminine and Israeli-Jewishness Others, service work is de-feminized and restructured as a welcome modern development whose traditional Other is cherished. The disadvantages of their national-minority status are compensated by cross-national amity and routine occupational practices in the modern workplace, whereby some of their Othering markers are prized. The national difference appears as a multiple-discursive resource which mainly separates the ethnic component from the political one by which the effects of gender, modern work and class structure, weaken. Four geographies, periphery, home-work links, the sociability of the place of work and the MENA world-region are identified, suggesting that geography is integral to the intersectional experience.

Understanding nature of empathy through the lens of service encounter: a phenomenological study on FLE's

Research suggests that every conceptual model of service organisations in the past 20 years has recognised that front line employees (FLEs) significantly influence the customer experience. In service front line employee and customer interaction, little is understood about the nature of empathy as a cognitive, an affective, or a multidimensional phenomenon. The purpose of this paper is to investigate the multidimensional nature of empathy. This phenomenological study focuses on how the theoretical discussion of the cognitive-affective nature of empathy finds expression in a service encounter. Conclusions in this study point to the ending that empathy has different meanings for different service frontline employees, when they are empathising with another customer. In probing the way service frontline employees experience empathy, it seems that both cognitive and affective aspects of this experience play a significant role and may appear either collectively or separately. The study provides some initial evidence on the conceptualisation of empathy and present findings add to the literature by focusing on the intrapersonal world of FLE's and examining how their empathetic behaviour relates to the customer.

Domo Arigato Mr. Roboto

Technology is rapidly changing the nature of service, customers’ service frontline experiences, and customers’ relationships with service providers. Based on the prediction that in the marketplace of 2025, technology (e.g., service-providing humanoid robots) will be melded into numerous service experiences, this article spotlights technology’s ability to engage customers on a social level as a critical advancement of technology infusions. Specifically, it introduces the novel concept of automated social presence (ASP; i.e., the extent to which technology makes customers feel the presence of another social entity) to the services literature. The authors develop a typology that highlights different combinations of automated and human social presence in organizational frontlines and indicates literature gaps, thereby emphasizing avenues for future research. Moreover, the article presents a conceptual framework that focuses on (a) how the relationship between ASP and several key service and customer outcomes is mediated by social cognition and perceptions of psychological ownership as well as (b) three customer-related factors that moderate the relationship between ASP and social cognition and psychological ownership (i.e., a customer’s relationship orientation, tendency to anthropomorphize, and technology readiness). Finally, propositions are presented that can be a catalyst for future work to enhance the understanding of how technology infusion, particularly service robots, influences customers’ frontline experiences in the future.

The Relationship Between Coping and Job Performance

Workers on the frontline of public service, such as teachers and social workers, cannot provide unlimited support to all their clients, because of among else scarce time and money. To deal with this, they use various coping strategies. We analyze one important coping strategy such “street-level bureaucrats” can use: prioritizing motivated clients over unmotivated clients. We study the effect of this coping strategy on job performance, as rated by their supervisors. In other words, do street-level bureaucrats who especially help motivated clients get lower or higher job performance ratings? By studying this relationship, we can test two narratives in frontline work: the state-agent narrative versus the citizen-agent narrative. If supervisors follow a state-agent narrative, they would give street-level bureaucrats that prioritize motivated clients lower performance ratings. Supervisors could stress values like legality and equality: workers should follow governmental rules and should treat all clients equally. Contrary to this, if supervisors follow a citizen-agent narrative, they would give street-level bureaucrats who especially help motivated clients higher performance ratings. Motivated clients are the “deserving clients,” worthy of investment. “Pushing” unmotivated clients may also be a very inefficient use of scarce resources. Using a multi-source study of social workers in one organization in the United States, we show that supervisors give higher job performance ratings to street-level bureaucrats who prioritize motivated clients. Implications of this finding and a future research agenda are shown.

Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods

Background: Psychiatric ward design may make an important contribution to patient outcomes and well-being. However, research is hampered by an inability to assess its effects robustly. This paper reports on a study which deployed innovative methods to capture service user and staff perceptions of ward design.Method: User generated measures of the impact of ward design were developed and tested on four acute adult wards using participatory methodology. Additionally, inpatients took photographs to illustrate their experience of the space in two wards. Data were compared across wards.Results: Satisfactory reliability indices emerged based on both service user and staff responses. Black and minority ethnic (BME) service users and those with a psychosis spectrum diagnosis have more positive views of the ward layout and fixtures. Staff members have more positive views than service users, while priorities of staff and service users differ. Inpatient photographs prioritise hygiene, privacy and control and address symbolic aspects of the ward environment.Conclusions: Participatory and visual methodologies can provide robust tools for an evaluation of the impact of psychiatric ward design on users.

Beyond Bureaucracy: How Prosecutors and Public Defenders Enforce Urban Planning Laws in São Paulo, Brazil

AbstractCities need law to thrive, but it is not clear how abstract texts become tangible policy outcomes. Existing research on the role of law in urban affairs conceives law as either an algorithm that shapes urban life or a reflection of political disputes. The former assumes that the meaning of law is obvious; the latter claims it is irrelevant. In contrast to these views, I argue that laws are multipurpose instruments that acquire a specific function when enforced by those government agents who operate at the frontlines of public service. To understand what these agents do and why, I conducted a qualitative study of the Ministério Público and the Defensoria Pública in São Paulo, Brazil. Through this process, I found that these government agencies are not cohesive bureaucracies but heterarchies composed of distinct internal factions with different evaluative principles. Moreover, officials within them are not isolated from other entities in society but tightly entangled with them, and these connections influence what these officials do. Finally, enforcement agents are not always resigned to solving conflicts as they arise. Rather, they strive to find acceptable solutions in the interstices of existing conditions or even change the circumstances that created the conflict in the first place.

Service brand and customer attire: a genetic algorithm approach

The service industry has given increasing attention to the significance of brand building. In order to understand and examine the relationships among service experience, perceived brand image and clothing choice, a literature-based conceptual model was developed and genetic algorithm approach was employed. Empirical data were collected from two steakhouses in Taiwan. The results of this study reported how clothing could be used and perceived in a social setting – restaurant. Our findings offer new insights and implications to service brand managers and frontline service employees on the areas of customer perceptions and expectations towards the brand through their clothing choices. In addition, practical strategies for constructing brand personality and customer service were recommended.

Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care.

BackgroundNew forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC.MethodsThe paper draws on observational, interview, and reflective data collected as part of the District Innovation and Action Learning for Health Systems Development (DIALHS) project being implemented in Cape Town, South Africa. Undertaken collaboratively between health managers and researchers, the project is implemented through cycles of action-learning, including systematic reflection and synthesis. It includes a particular focus on how local health managers can better support front line facility managers in strengthening PHC.ResultsThe results illuminate how the collective understandings of staff working at the primary level - of their working environment and changes within it – act as a barrier to centrally-led initiatives to strengthen PHC. Staff often fail to take ownership of such initiatives and experience them as disempowering. Local area managers, located between the centre and the service frontline, have a vital role to play in providing a leadership of sensemaking to mediate these challenges. Founded on personal values, such leadership entails, for example, efforts to nurture PHC-aligned values and mind-sets among staff; build relationships and support the development of shared meanings about change; instil a culture of collective inquiry and mutual accountability; and role-model management practices, including using language to signal meaning.ConclusionsPHC will only become a lived reality within the South African health system when frontline staff are able to make sense of policy intentions and incorporate them into their everyday routines and practices. This requires a leadership of sensemaking that enables front line staff to exercise their collective discretionary power in strengthening PHC. We hope this theoretically-framed analysis of one set of experiences stimulates wider thinking about the leadership needed to sustain primary health care in other settings.

Increasing Empathy Toward Older Adults With Dementia: Results of a Dementia Simulation

Baccalaureate-level social workers are often the front line of service for older adults with dementia. Therefore, future social workers must be provided knowledge, resources, and experiences to build the confidence and competence to work with clients exhibiting dementia symptoms at the undergraduate level. This study explores the impact of an experiential learning technique that provides undergraduate students in two introductory-level social work courses with an opportunity to participate in a dementia simulation. The simulation allows students to briefly experience life as an older adult with dementia. Results indicate that the simulation had a significant effect on the students' empathy toward and understanding of older adults with dementia.

Jaystudent Mystery Calling Experiments in Higher Education

There is a strong relationship between buyers’ perceived risk and their satisfaction in out-of-standard situations of services. The customer-specific feature of these situations has been modelled as jaycustomers, i.e. customers of nonstandard behaviour. In education - due to students’ expectations - the control of different situations is of high importance. The purpose of our research is to study administrative staff’s behaviour when they find themselves face-to-face with so called ’jaystudents’. To solve the problem of research, an interdisciplinary approach of psychology and marketing is needed. As far as methodology is concerned a basically qualitative experimental design has been selected with some quantifiable elements. The research process starts with a series of mystery callings followed by post-experimental focus group discussions. In service research mystery calling is usually applied for testing standards. As a new methodological approach of our research, the application of experimental techniques in exceptional service frontline situations can be mentioned. From managerial aspects the results can provide the management with realistic information on the weaknesses of frontline personnel and of frontline standards. They can serve to improve human resource management in higher education. Based on the results we are going to extend the investigations to face-to-face contexts.

OC-077 Is the Referral Appropriate?

IntroductionWith issues of increasing demand for endoscopy procedures, there is a need to validate surveillance referrals. A nurse-led review of surveillance referrals was set up. The aim was to ensure...

Organisational role stress and the function of selected organisational practices in reducing it: empirical evidence from the banking service front line in India

The present study examines the varying impacts of health, environmental, and organisational factors on organisational role stress. It uses survey data from 483 respondents representing the private and public banking sectors in Goa, India. Analysis shows that environmental factors, health practices, and demographics such as age, salary, and length of service are strong predictors of reduction in organisational role stress. Also, married couples experience less stress and females are subject to higher stress than males. The study adds to the evidence that environmental, health, and demographics at workplace are potential explanatory variables in finding lasting cures for workplace stress.

The effect of accent of service employee on customer service evaluation

PurposeThe primary objective of this paper is to investigate the attitudes, feelings and perceptions of Australian consumers towards service frontline employees with accents that differ from Standard Australian English, taking into consideration service‐country image and customer emotions.Design/methodology/approachThis paper reports on a qualitative study designed to uncover the attitudes and perceptions of Australians towards service personnel with foreign accents.FindingsThe findings revealed that hearing a service provider with a foreign accent, particularly in services encounters without face‐to‐face contacts, often evokes a negative predisposition to certain accents, reduces the customers' level of tolerance and increases the perception of the service provider's lack of understanding. This negative stereotype bias seems to be moderated by the accent (a proxy of ethnicity) and service‐country image and influenced by customer emotions in the service interaction.Research limitations/implicationsFuture studies could also use a controlled experimental design where accent could be used as a sensory cue to further test the validity and reliability of the current findings while controlling for factors such as ethnic background, employment, education and age. Further research should also take service types and service outcomes into consideration in examining the effect of accents on customer service evaluation.Practical implicationsAccent as a service employee attribute influences customers' evaluation of the service encounter because of the stereotype customers have. Training in language skills, cross‐cultural interpersonal skills and authority to deviate from the script should be given to minimise the negative effect of service employee accent. Service firms also need to develop strategies to manage customer emotions and reactions.Originality/valueThis paper contributes to the service literature about service employee attributes and is particularly relevant to economies such as the USA, Canada, the UK, New Zealand and Australia where immigrants are a large part of the service workforce.

A study of consumer perception of smiling customer service within the airline industry

Smiling customer service has been the gold standard for American businesses since the early 1900s when “service with a smile” became a popular slogan for many businesses. Today, cutbacks, add-on fees, and airlines’ struggle to survive have placed unprecedented stresses on airline employees who deal with the public. Since 9/11 the airline industry and its shortcomings have been in the spotlight. Travelers often arrive hostile at boarding gates, feeling taken advantage of despite low fares. A smile seems a fragile defense against an angry public, yet a smile has power. This paper proposes that smiling while serving customers is a visible manifestation of the core values of respect, compassion, and hospitality, the foundations of excellent customer service. Patience and courtesy show themselves in the outward behavior of smiling while helping customers, and customers usually react well when attended by frontline staff whose smiles demonstrate they are putting the customer first. Smiling customer service works as airline employees show understanding, patience, attention to details, excellent listening skills, a willing spirit, resourcefulness, etc. In other words, service providers or frontline staff are willing to go above and beyond their job description to ensure total customer satisfaction. This research paper presents the results of an empirical study of customer reactions to smiling customer service. For purposes of the study, the smiles involved were considered both literally and figuratively. The aim was to discover the results when service providers or frontline staff actually did “smile” when handling or resolving explosive customer service issues.

Bridging the Gaps among Social Justice, Research, and Practice

As workers, we are charged with carrying out the ethical promotion of justice as well as partnering with underserved and oppressed populations to create change. These populations are largely excluded from major spheres of public and economic life (Strier, 2006). Social justice is, in essence, an organizing value for our work that distinguishes us from other professions. Researchers and practitioners must work together to ensure that our efforts are informed by the core value of Social work researchers need to collaborate with practitioners in pursuit of the professions' mutual goal of dismantling inequitable access to systems and societal structures. Social work practitioners are vital partners in the justice and research process. Researchers need these partnerships to understand issues and factors that affect disproportionate health and mental health outcomes and how societal and organizational structures affect interactions with clients' use (or lack of use) of services. Micro- and macro-level work practitioners are critical resources in data-collection efforts because they are on the frontlines of service and have relationships with consumers and communities. Enhanced opportunities exist to involve individuals and communities affected by oppression in an active and genuine role in the research process. It goes without saying that much work remains to be done in the area of Our efforts as a profession should focus on cultivating greater participation between work researchers and practitioners in conducting meaningful, translatable research that bridges the gaps among justice, research, and practice. Many scholars have noted that justice is a much needed goal; however, its conceptual formulation and application are often vague and abstruse. Operationally, there is often no singular definition of the term social justice. Rather, the conceptualization is vague and open to various interpretations. A working definition of injustice, provided by Strier (2006), refers to the systemic subordination of specific groups through the institutionalized use of unjust power and authority (p. 860). In addition to what is often viewed as an ambiguous delineation of justice, there is often sparse information about how to translate justice concepts into action. When Hong and Hodge (2009) asked work professors to define justice, the responses revealed pronounced obscurity regarding conceptualization of the term. Still, several colleagues have made headway in introducing frameworks that assist the profession in methodological approaches and strategies to move us toward a just society (Dempsey, 2008; Fin J Sakamoto & Pitner, 2005; Salas, Sen, & Segal, 2010; Vodde & Gallant, 2002). Because the conception of justice can differ on the basis of level of practice, the meaning of this term may change depending on whether one is working directly with clients or in an administrative position. Some researchers have referred to this schism as a work dichotomy (Salas et al., 2010; Vodde & Gallant, 2002). Some have argued that distinctions between micro and macro practice should be eliminated, that without such unification the path to justice may be unattainable. In our view, regardless of roles, work researchers and practitioners must work together to dismantle the systems and structures that function to preserve inequity. Critical theory is an important operating framework that encourages workers to critically analyze and reflect systematically and contextually about oppression. From this process, a new awareness evolves that must convert reflection into action. Social work researchers can play a unique role in the translation of research to practice by engaging practitioners in the careful analysis of study results and identifying how the implementation of the evidence can dismantle systematic oppression. …

Co-designing for Society

Healthcare is the issue that touches the lives of everyone. Adapting, changing and continually innovating healthcare is a complex undertaking requiring contributions from many different stakeholders including governments, professionals, carers, patients and the general public. But how do these groups come together, work together and share ownership in identifying challenges and creating and delivering solutions for the future of healthcare? thinkpublic is a multi-disciplinary social innovation and design agency. We aim to design better healthcare and develop lasting skills and capacity among service providers and users. We do this by using an approach called co-design. Our approach of co-design is grounded in understanding the real life experiences, ideas and skills of people, who use, need and run services. In the first Design + Health edition of the Australasian Medical Journal (AMJ) we presented Alzheimer100 [1] a project where co-design was used to collaboratively identify issues in dementia and develop a range of innovative responses that addressed them. In this paper, we build and elaborate on co-design, outlining in more detail its approach, tools, processes and practices. We will illustrate co-design through several projects we have undertaken such as: • Engaging residents of a council estate to improve health and wellbeing indicators; • Co-designing Perinatal Mental Health services; and • Implementing a dementia care service from the Alzheimer100 project. We will also discuss the results and benefits of co-design projects including: • Services that are more user-centred and more efficient; • More active citizens who can save the state money; • Unlocking sources of innovation at the service frontline; • The utilisation of limited resources that reach their maximum potential; • The output of creative solutions tailored to the real needs of people; • The creation of social capital; • The creation of buy-in and goodwill of key stakeholders; • Reinvigorated trust between citizens and the public sector; and • Empowered people who take more responsibility for their own well-being and the future. At thinkpublic we believe that co-design has a crucial part to play in the future of healthcare and services. Through co-design we believe that health services and care can be better for patients, professionals, carers and other stakeholders of one of the most significant issues of our time.

Welfare wars: public service frontline absenteeism as collective resistance

PurposeThe purpose of this paper is to develop a model to explain frontline employee absence as a form of concerted resistance in a public service welfare environment.Design/methodology/approachConflicts over absenteeism can be interpreted as a mix of formal and informal struggles over the effort bargain. Centrelink workers' use of “unplanned leave” between 2005 and 2007 involved the quasi‐collective use of a formal entitlement in a form of misbehaviour that defied management control.FindingsWhereas absenteeism is normally assumed to be a form of unorganised individual time‐theft, in this study it became a tacitly‐agreed form of collective resistance and a way of affirming collectively negotiated rights.Research limitations/implicationsThis paper explores how the toll of cost cutting and implementation of tighter welfare eligibility rules elicited collective resistance through leave taking and highlights how absenteeism can be more than an individual response of passive disengagement.Originality/valueUsing theories of resistance, the authors highlight how the case study both conforms to and departs from the received wisdom about absenteeism as an individual oppositional strategy.

Automating object-oriented integration and visualization of multidisciplinary biomedical data in radiology workflow: Compartmental PACS model

This paper is aimed to present a novel compartmental PACS model for the automatic object-oriented integration and visualization of heterogeneous data for the multidisciplinary biomedical studies in the midst of the imaging services in radiology department. The generic PACS is conceptually partitioned into two compartments: service and integration. The service compartment supports the routine imaging service by connecting the imaging modalities to the web client workstations through a single fault-tolerant hardware. The integration compartment is synthesized by open source and open standard software tools to perform the long-term archiving of imaging cases and to integrate the images with the related data from other clinical disciplines. The prototype of the compartmental PACS model has been successfully implemented in the Department of Health Technology and Informatics (HTI) at the Hong Kong Polytechnic University (PolyU). Multi-disciplinary study on a cardiovascular case is considered as an example in this paper to demonstrate the seamless integration and web-based visualization of heterogeneous data from radiology, ophthalmology, cardiology and hematology. The implementation of the compartmental PACS model demonstrates a deliberative system design for allocating mission-critical components at the clinical frontline of imaging services and long-term archiving components at the backend. The integrative feature of object-oriented long-term archive addresses the comprehensive needs of patient-centered multidisciplinary biomedical studies.